|
HC NEG PRES WND THRPY DSG SET SIL
|
Facility
|
IP
|
$272.48
|
|
| Hospital Charge Code |
27200140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$177.11 |
| Max. Negotiated Rate |
$245.23 |
| Rate for Payer: Aetna Commercial |
$231.61
|
| Rate for Payer: BCBS Trust/PPO |
$222.43
|
| Rate for Payer: BCN Commercial |
$210.57
|
| Rate for Payer: Cash Price |
$217.98
|
| Rate for Payer: Cofinity Commercial |
$234.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.98
|
| Rate for Payer: Healthscope Commercial |
$245.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.61
|
| Rate for Payer: Nomi Health Commercial |
$223.43
|
| Rate for Payer: PHP Commercial |
$231.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.11
|
| Rate for Payer: Priority Health HMO/PPO |
$237.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.78
|
| Rate for Payer: UHC Core |
$227.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.36
|
|
|
HC NEG PRES WND THRPY DSG SET SMA
|
Facility
|
IP
|
$115.99
|
|
| Hospital Charge Code |
27200141
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.39 |
| Max. Negotiated Rate |
$104.39 |
| Rate for Payer: Aetna Commercial |
$98.59
|
| Rate for Payer: BCBS Trust/PPO |
$94.68
|
| Rate for Payer: BCN Commercial |
$89.64
|
| Rate for Payer: Cash Price |
$92.79
|
| Rate for Payer: Cofinity Commercial |
$99.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.79
|
| Rate for Payer: Healthscope Commercial |
$104.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.59
|
| Rate for Payer: Nomi Health Commercial |
$95.11
|
| Rate for Payer: PHP Commercial |
$98.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.39
|
| Rate for Payer: Priority Health HMO/PPO |
$100.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.07
|
| Rate for Payer: UHC Core |
$96.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.99
|
|
|
HC NEG PRES WND THRPY DSG SET SMA
|
Facility
|
OP
|
$115.99
|
|
| Hospital Charge Code |
27200141
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.55 |
| Max. Negotiated Rate |
$104.39 |
| Rate for Payer: Aetna Commercial |
$98.59
|
| Rate for Payer: Aetna Medicare |
$30.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.25
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: BCBS MAPPO |
$29.00
|
| Rate for Payer: BCBS Trust/PPO |
$95.36
|
| Rate for Payer: BCN Commercial |
$90.18
|
| Rate for Payer: BCN Medicare Advantage |
$29.00
|
| Rate for Payer: Cash Price |
$92.79
|
| Rate for Payer: Cofinity Commercial |
$99.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.00
|
| Rate for Payer: Healthscope Commercial |
$104.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.59
|
| Rate for Payer: Nomi Health Commercial |
$95.11
|
| Rate for Payer: PACE Senior Care Partners |
$27.55
|
| Rate for Payer: PACE SWMI |
$29.00
|
| Rate for Payer: PHP Commercial |
$98.59
|
| Rate for Payer: PHP Medicare Advantage |
$29.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.39
|
| Rate for Payer: Priority Health HMO/PPO |
$100.91
|
| Rate for Payer: Priority Health Medicare |
$29.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.71
|
| Rate for Payer: Railroad Medicare Medicare |
$29.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.07
|
| Rate for Payer: UHC Core |
$96.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.00
|
| Rate for Payer: UHC Exchange |
$29.00
|
| Rate for Payer: UHC Medicare Advantage |
$29.00
|
| Rate for Payer: VA VA |
$29.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.99
|
|
|
HC NEG PRES WOUND TX SET MED
|
Facility
|
IP
|
$79.99
|
|
| Hospital Charge Code |
27200127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.99 |
| Max. Negotiated Rate |
$71.99 |
| Rate for Payer: Aetna Commercial |
$67.99
|
| Rate for Payer: BCBS Trust/PPO |
$65.30
|
| Rate for Payer: BCN Commercial |
$61.82
|
| Rate for Payer: Cash Price |
$63.99
|
| Rate for Payer: Cofinity Commercial |
$68.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.99
|
| Rate for Payer: Healthscope Commercial |
$71.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.99
|
| Rate for Payer: Nomi Health Commercial |
$65.59
|
| Rate for Payer: PHP Commercial |
$67.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.99
|
| Rate for Payer: Priority Health HMO/PPO |
$69.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.39
|
| Rate for Payer: UHC Core |
$66.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.99
|
|
|
HC NEG PRES WOUND TX SET MED
|
Facility
|
OP
|
$79.99
|
|
| Hospital Charge Code |
27200127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$71.99 |
| Rate for Payer: Aetna Commercial |
$67.99
|
| Rate for Payer: Aetna Medicare |
$20.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.00
|
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: BCBS MAPPO |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$65.76
|
| Rate for Payer: BCN Commercial |
$62.19
|
| Rate for Payer: BCN Medicare Advantage |
$20.00
|
| Rate for Payer: Cash Price |
$63.99
|
| Rate for Payer: Cofinity Commercial |
$68.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$71.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.99
|
| Rate for Payer: Nomi Health Commercial |
$65.59
|
| Rate for Payer: PACE Senior Care Partners |
$19.00
|
| Rate for Payer: PACE SWMI |
$20.00
|
| Rate for Payer: PHP Commercial |
$67.99
|
| Rate for Payer: PHP Medicare Advantage |
$20.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.99
|
| Rate for Payer: Priority Health HMO/PPO |
$69.59
|
| Rate for Payer: Priority Health Medicare |
$20.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.59
|
| Rate for Payer: Railroad Medicare Medicare |
$20.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.39
|
| Rate for Payer: UHC Core |
$66.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.00
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHC Medicare Advantage |
$20.00
|
| Rate for Payer: VA VA |
$20.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.99
|
|
|
HC NEG PRES WOUND TX SET SMALL
|
Facility
|
IP
|
$115.99
|
|
| Hospital Charge Code |
27200128
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.39 |
| Max. Negotiated Rate |
$104.39 |
| Rate for Payer: Aetna Commercial |
$98.59
|
| Rate for Payer: BCBS Trust/PPO |
$94.68
|
| Rate for Payer: BCN Commercial |
$89.64
|
| Rate for Payer: Cash Price |
$92.79
|
| Rate for Payer: Cofinity Commercial |
$99.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.79
|
| Rate for Payer: Healthscope Commercial |
$104.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.59
|
| Rate for Payer: Nomi Health Commercial |
$95.11
|
| Rate for Payer: PHP Commercial |
$98.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.39
|
| Rate for Payer: Priority Health HMO/PPO |
$100.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.07
|
| Rate for Payer: UHC Core |
$96.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.99
|
|
|
HC NEG PRES WOUND TX SET SMALL
|
Facility
|
OP
|
$115.99
|
|
| Hospital Charge Code |
27200128
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.55 |
| Max. Negotiated Rate |
$104.39 |
| Rate for Payer: Aetna Commercial |
$98.59
|
| Rate for Payer: Aetna Medicare |
$30.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.25
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: BCBS MAPPO |
$29.00
|
| Rate for Payer: BCBS Trust/PPO |
$95.36
|
| Rate for Payer: BCN Commercial |
$90.18
|
| Rate for Payer: BCN Medicare Advantage |
$29.00
|
| Rate for Payer: Cash Price |
$92.79
|
| Rate for Payer: Cofinity Commercial |
$99.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.00
|
| Rate for Payer: Healthscope Commercial |
$104.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.59
|
| Rate for Payer: Nomi Health Commercial |
$95.11
|
| Rate for Payer: PACE Senior Care Partners |
$27.55
|
| Rate for Payer: PACE SWMI |
$29.00
|
| Rate for Payer: PHP Commercial |
$98.59
|
| Rate for Payer: PHP Medicare Advantage |
$29.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.39
|
| Rate for Payer: Priority Health HMO/PPO |
$100.91
|
| Rate for Payer: Priority Health Medicare |
$29.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.71
|
| Rate for Payer: Railroad Medicare Medicare |
$29.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.07
|
| Rate for Payer: UHC Core |
$96.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.00
|
| Rate for Payer: UHC Exchange |
$29.00
|
| Rate for Payer: UHC Medicare Advantage |
$29.00
|
| Rate for Payer: VA VA |
$29.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.99
|
|
|
HC NEG PRES Y CONNECTOR
|
Facility
|
OP
|
$7.86
|
|
| Hospital Charge Code |
27000174
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$7.07 |
| Rate for Payer: Aetna Commercial |
$6.68
|
| Rate for Payer: Aetna Medicare |
$2.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.46
|
| Rate for Payer: BCBS Complete |
$3.14
|
| Rate for Payer: BCBS MAPPO |
$1.96
|
| Rate for Payer: BCBS Trust/PPO |
$6.46
|
| Rate for Payer: BCN Commercial |
$6.11
|
| Rate for Payer: BCN Medicare Advantage |
$1.96
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cofinity Commercial |
$6.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.96
|
| Rate for Payer: Healthscope Commercial |
$7.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.68
|
| Rate for Payer: Nomi Health Commercial |
$6.45
|
| Rate for Payer: PACE Senior Care Partners |
$1.87
|
| Rate for Payer: PACE SWMI |
$1.96
|
| Rate for Payer: PHP Commercial |
$6.68
|
| Rate for Payer: PHP Medicare Advantage |
$1.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.11
|
| Rate for Payer: Priority Health HMO/PPO |
$6.84
|
| Rate for Payer: Priority Health Medicare |
$1.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.92
|
| Rate for Payer: UHC Core |
$6.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Medicare Advantage |
$1.96
|
| Rate for Payer: VA VA |
$1.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.90
|
|
|
HC NEG PRES Y CONNECTOR
|
Facility
|
IP
|
$7.86
|
|
| Hospital Charge Code |
27000174
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$7.07 |
| Rate for Payer: Aetna Commercial |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$6.42
|
| Rate for Payer: BCN Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cofinity Commercial |
$6.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.29
|
| Rate for Payer: Healthscope Commercial |
$7.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.68
|
| Rate for Payer: Nomi Health Commercial |
$6.45
|
| Rate for Payer: PHP Commercial |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.11
|
| Rate for Payer: Priority Health HMO/PPO |
$6.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.92
|
| Rate for Payer: UHC Core |
$6.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.90
|
|
|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.21
|
| Rate for Payer: BCN Commercial |
$52.26
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$52.58
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.91
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
IP
|
$1,569.06
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,019.89 |
| Max. Negotiated Rate |
$1,412.15 |
| Rate for Payer: Aetna Commercial |
$1,333.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.82
|
| Rate for Payer: BCN Commercial |
$1,212.57
|
| Rate for Payer: Cash Price |
$1,255.25
|
| Rate for Payer: Cofinity Commercial |
$1,349.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.25
|
| Rate for Payer: Healthscope Commercial |
$1,412.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.70
|
| Rate for Payer: Nomi Health Commercial |
$1,286.63
|
| Rate for Payer: PHP Commercial |
$1,333.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.89
|
| Rate for Payer: Priority Health HMO/PPO |
$1,365.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.77
|
| Rate for Payer: UHC Core |
$1,310.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.80
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
OP
|
$1,569.06
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$372.65 |
| Max. Negotiated Rate |
$1,412.15 |
| Rate for Payer: Aetna Commercial |
$1,333.70
|
| Rate for Payer: Aetna Medicare |
$407.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.33
|
| Rate for Payer: BCBS Complete |
$491.76
|
| Rate for Payer: BCBS MAPPO |
$392.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.92
|
| Rate for Payer: BCN Commercial |
$1,219.94
|
| Rate for Payer: BCN Medicare Advantage |
$392.26
|
| Rate for Payer: Cash Price |
$1,255.25
|
| Rate for Payer: Cash Price |
$1,255.25
|
| Rate for Payer: Cofinity Commercial |
$1,349.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.26
|
| Rate for Payer: Healthscope Commercial |
$1,412.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.80
|
| Rate for Payer: Mclaren Medicaid |
$468.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.88
|
| Rate for Payer: Meridian Medicaid |
$491.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.70
|
| Rate for Payer: Nomi Health Commercial |
$1,286.63
|
| Rate for Payer: PACE Senior Care Partners |
$372.65
|
| Rate for Payer: PACE SWMI |
$392.26
|
| Rate for Payer: PHP Commercial |
$1,333.70
|
| Rate for Payer: PHP Medicare Advantage |
$392.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.89
|
| Rate for Payer: Priority Health HMO/PPO |
$1,365.08
|
| Rate for Payer: Priority Health Medicare |
$396.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.27
|
| Rate for Payer: Railroad Medicare Medicare |
$392.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.77
|
| Rate for Payer: UHC Core |
$1,310.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.26
|
| Rate for Payer: UHC Exchange |
$392.26
|
| Rate for Payer: UHC Medicare Advantage |
$392.26
|
| Rate for Payer: UHCCP Medicaid |
$468.31
|
| Rate for Payer: VA VA |
$392.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.80
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
OP
|
$1,197.45
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$284.39 |
| Max. Negotiated Rate |
$1,077.70 |
| Rate for Payer: Aetna Commercial |
$1,017.83
|
| Rate for Payer: Aetna Medicare |
$311.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$374.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$374.20
|
| Rate for Payer: BCBS Complete |
$491.76
|
| Rate for Payer: BCBS MAPPO |
$299.36
|
| Rate for Payer: BCBS Trust/PPO |
$984.42
|
| Rate for Payer: BCN Commercial |
$931.02
|
| Rate for Payer: BCN Medicare Advantage |
$299.36
|
| Rate for Payer: Cash Price |
$957.96
|
| Rate for Payer: Cash Price |
$957.96
|
| Rate for Payer: Cofinity Commercial |
$1,029.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$957.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.36
|
| Rate for Payer: Healthscope Commercial |
$1,077.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.09
|
| Rate for Payer: Mclaren Medicaid |
$468.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.33
|
| Rate for Payer: Meridian Medicaid |
$491.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$344.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.83
|
| Rate for Payer: Nomi Health Commercial |
$981.91
|
| Rate for Payer: PACE Senior Care Partners |
$284.39
|
| Rate for Payer: PACE SWMI |
$299.36
|
| Rate for Payer: PHP Commercial |
$1,017.83
|
| Rate for Payer: PHP Medicare Advantage |
$299.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.34
|
| Rate for Payer: Priority Health HMO/PPO |
$1,041.78
|
| Rate for Payer: Priority Health Medicare |
$302.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.29
|
| Rate for Payer: Railroad Medicare Medicare |
$299.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,053.76
|
| Rate for Payer: UHC Core |
$999.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.36
|
| Rate for Payer: UHC Exchange |
$299.36
|
| Rate for Payer: UHC Medicare Advantage |
$299.36
|
| Rate for Payer: UHCCP Medicaid |
$468.31
|
| Rate for Payer: VA VA |
$299.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.09
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
IP
|
$1,197.45
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$778.34 |
| Max. Negotiated Rate |
$1,077.70 |
| Rate for Payer: Aetna Commercial |
$1,017.83
|
| Rate for Payer: BCBS Trust/PPO |
$977.48
|
| Rate for Payer: BCN Commercial |
$925.39
|
| Rate for Payer: Cash Price |
$957.96
|
| Rate for Payer: Cofinity Commercial |
$1,029.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$957.96
|
| Rate for Payer: Healthscope Commercial |
$1,077.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.83
|
| Rate for Payer: Nomi Health Commercial |
$981.91
|
| Rate for Payer: PHP Commercial |
$1,017.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.34
|
| Rate for Payer: Priority Health HMO/PPO |
$1,041.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,053.76
|
| Rate for Payer: UHC Core |
$999.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.09
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
OP
|
$1,363.87
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.92 |
| Max. Negotiated Rate |
$1,227.48 |
| Rate for Payer: Aetna Commercial |
$1,159.29
|
| Rate for Payer: Aetna Medicare |
$354.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$426.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$426.21
|
| Rate for Payer: BCBS Complete |
$496.49
|
| Rate for Payer: BCBS MAPPO |
$340.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,121.24
|
| Rate for Payer: BCN Commercial |
$1,060.41
|
| Rate for Payer: BCN Medicare Advantage |
$340.97
|
| Rate for Payer: Cash Price |
$1,091.10
|
| Rate for Payer: Cash Price |
$1,091.10
|
| Rate for Payer: Cofinity Commercial |
$1,172.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,091.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.97
|
| Rate for Payer: Healthscope Commercial |
$1,227.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,022.90
|
| Rate for Payer: Mclaren Medicaid |
$472.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.02
|
| Rate for Payer: Meridian Medicaid |
$496.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$392.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,159.29
|
| Rate for Payer: Nomi Health Commercial |
$1,118.37
|
| Rate for Payer: PACE Senior Care Partners |
$323.92
|
| Rate for Payer: PACE SWMI |
$340.97
|
| Rate for Payer: PHP Commercial |
$1,159.29
|
| Rate for Payer: PHP Medicare Advantage |
$340.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$886.52
|
| Rate for Payer: Priority Health HMO/PPO |
$1,186.57
|
| Rate for Payer: Priority Health Medicare |
$344.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$913.79
|
| Rate for Payer: Railroad Medicare Medicare |
$340.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.21
|
| Rate for Payer: UHC Core |
$1,138.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$340.97
|
| Rate for Payer: UHC Exchange |
$340.97
|
| Rate for Payer: UHC Medicare Advantage |
$340.97
|
| Rate for Payer: UHCCP Medicaid |
$472.82
|
| Rate for Payer: VA VA |
$340.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,022.90
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
IP
|
$1,363.87
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$886.52 |
| Max. Negotiated Rate |
$1,227.48 |
| Rate for Payer: Aetna Commercial |
$1,159.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.33
|
| Rate for Payer: BCN Commercial |
$1,054.00
|
| Rate for Payer: Cash Price |
$1,091.10
|
| Rate for Payer: Cofinity Commercial |
$1,172.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,091.10
|
| Rate for Payer: Healthscope Commercial |
$1,227.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,022.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,159.29
|
| Rate for Payer: Nomi Health Commercial |
$1,118.37
|
| Rate for Payer: PHP Commercial |
$1,159.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$886.52
|
| Rate for Payer: Priority Health HMO/PPO |
$1,186.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$913.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.21
|
| Rate for Payer: UHC Core |
$1,138.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,022.90
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
IP
|
$1,204.40
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$782.86 |
| Max. Negotiated Rate |
$1,083.96 |
| Rate for Payer: Aetna Commercial |
$1,023.74
|
| Rate for Payer: BCBS Trust/PPO |
$983.15
|
| Rate for Payer: BCN Commercial |
$930.76
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cofinity Commercial |
$1,035.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.52
|
| Rate for Payer: Healthscope Commercial |
$1,083.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.74
|
| Rate for Payer: Nomi Health Commercial |
$987.61
|
| Rate for Payer: PHP Commercial |
$1,023.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,047.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.87
|
| Rate for Payer: UHC Core |
$1,005.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.30
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
OP
|
$1,204.40
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$286.04 |
| Max. Negotiated Rate |
$1,083.96 |
| Rate for Payer: Aetna Commercial |
$1,023.74
|
| Rate for Payer: Aetna Medicare |
$313.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.38
|
| Rate for Payer: BCBS Complete |
$496.49
|
| Rate for Payer: BCBS MAPPO |
$301.10
|
| Rate for Payer: BCBS Trust/PPO |
$990.14
|
| Rate for Payer: BCN Commercial |
$936.42
|
| Rate for Payer: BCN Medicare Advantage |
$301.10
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cofinity Commercial |
$1,035.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.10
|
| Rate for Payer: Healthscope Commercial |
$1,083.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.30
|
| Rate for Payer: Mclaren Medicaid |
$472.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.16
|
| Rate for Payer: Meridian Medicaid |
$496.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.74
|
| Rate for Payer: Nomi Health Commercial |
$987.61
|
| Rate for Payer: PACE Senior Care Partners |
$286.04
|
| Rate for Payer: PACE SWMI |
$301.10
|
| Rate for Payer: PHP Commercial |
$1,023.74
|
| Rate for Payer: PHP Medicare Advantage |
$301.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,047.83
|
| Rate for Payer: Priority Health Medicare |
$304.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.95
|
| Rate for Payer: Railroad Medicare Medicare |
$301.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.87
|
| Rate for Payer: UHC Core |
$1,005.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.10
|
| Rate for Payer: UHC Exchange |
$301.10
|
| Rate for Payer: UHC Medicare Advantage |
$301.10
|
| Rate for Payer: UHCCP Medicaid |
$472.82
|
| Rate for Payer: VA VA |
$301.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.30
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
IP
|
$1,491.41
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$969.42 |
| Max. Negotiated Rate |
$1,342.27 |
| Rate for Payer: Aetna Commercial |
$1,267.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,217.44
|
| Rate for Payer: BCN Commercial |
$1,152.56
|
| Rate for Payer: Cash Price |
$1,193.13
|
| Rate for Payer: Cofinity Commercial |
$1,282.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.13
|
| Rate for Payer: Healthscope Commercial |
$1,342.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,267.70
|
| Rate for Payer: Nomi Health Commercial |
$1,222.96
|
| Rate for Payer: PHP Commercial |
$1,267.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,297.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$999.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,312.44
|
| Rate for Payer: UHC Core |
$1,245.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.56
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
OP
|
$1,491.41
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$354.21 |
| Max. Negotiated Rate |
$1,342.27 |
| Rate for Payer: Aetna Commercial |
$1,267.70
|
| Rate for Payer: Aetna Medicare |
$387.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.07
|
| Rate for Payer: BCBS Complete |
$662.24
|
| Rate for Payer: BCBS MAPPO |
$372.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,226.09
|
| Rate for Payer: BCN Commercial |
$1,159.57
|
| Rate for Payer: BCN Medicare Advantage |
$372.85
|
| Rate for Payer: Cash Price |
$1,193.13
|
| Rate for Payer: Cash Price |
$1,193.13
|
| Rate for Payer: Cofinity Commercial |
$1,282.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.85
|
| Rate for Payer: Healthscope Commercial |
$1,342.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.56
|
| Rate for Payer: Mclaren Medicaid |
$630.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.50
|
| Rate for Payer: Meridian Medicaid |
$662.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$428.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,267.70
|
| Rate for Payer: Nomi Health Commercial |
$1,222.96
|
| Rate for Payer: PACE Senior Care Partners |
$354.21
|
| Rate for Payer: PACE SWMI |
$372.85
|
| Rate for Payer: PHP Commercial |
$1,267.70
|
| Rate for Payer: PHP Medicare Advantage |
$372.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,297.53
|
| Rate for Payer: Priority Health Medicare |
$376.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$999.24
|
| Rate for Payer: Railroad Medicare Medicare |
$372.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,312.44
|
| Rate for Payer: UHC Core |
$1,245.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.85
|
| Rate for Payer: UHC Exchange |
$372.85
|
| Rate for Payer: UHC Medicare Advantage |
$372.85
|
| Rate for Payer: UHCCP Medicaid |
$630.67
|
| Rate for Payer: VA VA |
$372.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.56
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
OP
|
$758.70
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$180.19 |
| Max. Negotiated Rate |
$682.83 |
| Rate for Payer: Aetna Commercial |
$644.90
|
| Rate for Payer: Aetna Medicare |
$197.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$237.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$237.09
|
| Rate for Payer: BCBS Complete |
$515.13
|
| Rate for Payer: BCBS MAPPO |
$189.68
|
| Rate for Payer: BCBS Trust/PPO |
$623.73
|
| Rate for Payer: BCN Commercial |
$589.89
|
| Rate for Payer: BCN Medicare Advantage |
$189.68
|
| Rate for Payer: Cash Price |
$606.96
|
| Rate for Payer: Cash Price |
$606.96
|
| Rate for Payer: Cofinity Commercial |
$652.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.68
|
| Rate for Payer: Healthscope Commercial |
$682.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$569.02
|
| Rate for Payer: Mclaren Medicaid |
$490.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.16
|
| Rate for Payer: Meridian Medicaid |
$515.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$644.90
|
| Rate for Payer: Nomi Health Commercial |
$622.13
|
| Rate for Payer: PACE Senior Care Partners |
$180.19
|
| Rate for Payer: PACE SWMI |
$189.68
|
| Rate for Payer: PHP Commercial |
$644.90
|
| Rate for Payer: PHP Medicare Advantage |
$189.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.16
|
| Rate for Payer: Priority Health HMO/PPO |
$660.07
|
| Rate for Payer: Priority Health Medicare |
$191.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$508.33
|
| Rate for Payer: Railroad Medicare Medicare |
$189.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.66
|
| Rate for Payer: UHC Core |
$633.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.68
|
| Rate for Payer: UHC Exchange |
$189.68
|
| Rate for Payer: UHC Medicare Advantage |
$189.68
|
| Rate for Payer: UHCCP Medicaid |
$490.57
|
| Rate for Payer: VA VA |
$189.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$569.02
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
IP
|
$758.70
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$493.16 |
| Max. Negotiated Rate |
$682.83 |
| Rate for Payer: Aetna Commercial |
$644.90
|
| Rate for Payer: BCBS Trust/PPO |
$619.33
|
| Rate for Payer: BCN Commercial |
$586.32
|
| Rate for Payer: Cash Price |
$606.96
|
| Rate for Payer: Cofinity Commercial |
$652.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.96
|
| Rate for Payer: Healthscope Commercial |
$682.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$569.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$644.90
|
| Rate for Payer: Nomi Health Commercial |
$622.13
|
| Rate for Payer: PHP Commercial |
$644.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.16
|
| Rate for Payer: Priority Health HMO/PPO |
$660.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$508.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.66
|
| Rate for Payer: UHC Core |
$633.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$569.02
|
|
